Confidential Therapy for Pilots and Aviation Professionals
The FAA put it in writing: therapy is compatible with a medical certificate
In May 2026 the FAA published guidance for pilots, controllers, and the psychotherapists who treat them, stating that counseling is encouraged when medically appropriate and that psychotherapy is compatible with an unrestricted medical certificate. CEREVITY matches pilots with licensed clinicians who know the aeromedical system and will tell you the truth about it, including the parts you will not like. 100% virtual. Private-pay.
The question every pilot asks first
Will talking to someone cost me my medical certificate?
Aviation runs on crew-room rumor about this, and a good deal of the rumor is out of date. Here is what is actually documented, including the part that is inconvenient.
The FAA says psychotherapy is compatible with flying
On May 27, 2026 the FAA added documents to the Guide for Aviation Medical Examiners, one of them written for the psychotherapists who treat you. The language is plain: counseling or therapy is encouraged when medically appropriate, and psychotherapy is compatible with both an unrestricted medical certificate and a special issuance. The FAA also states that speaking with a therapist does not by itself create a diagnosis; the therapist makes an assessment, which may or may not become one.
We report nothing. What you report is yours, and we will not guess at it
CEREVITY files nothing with the FAA, your AME, or your airline, and we have no channel to any of them. Private-pay means no insurance claim, no diagnosis code, and no carrier record, because none is ever created. What you are obliged to disclose on a medical application is a separate question: it is governed by FAA rules, it turns on your own circumstances, and it is not something a website should decide for you. Your clinician will go through the FAA's published guidance with you honestly rather than pretend the question away.
Your records rarely travel, and ours are built for the day they might
The FAA's own published answer to whether it will see your therapy records is: usually not, and when documentation is requested it is usually a brief summary from the therapist. The agency also published guidance addressed to the psychotherapists who treat pilots: keep process notes separate from progress notes, write in precise DSM-5-TR language, and neither inflate nor minimize. It closes by telling therapists unwilling to work that way to think hard before taking a pilot as a client. Most therapists have never read that document. Ours work to it.
What actually walks into session with a pilot
Six patterns our clinicians see in aviation professionals every week. None of them start with a bad day.
The silence that is trained in
You learned early that the safe answer to every medical question is no. That habit does not stay confined to the exam room, and it is precisely what the new guidance is trying to undo.
A life measured in cycles
Body clock permanently displaced, sleep debt as a professional condition, and a physiology that never fully lands.
The marriage conducted by text
Home four days out of fourteen, an entire domestic life happening without you, and the strange status of a guest in your own house.
Grief and incident carryover
The event you flew through, the loss you took a leave for, the diversion that still runs on a loop, and a job where you are expected to be the calm one.
Retirement as a cliff
A mandatory end date and an identity built entirely on the left seat, approaching at a known speed.
Alcohol at the edge of the rules
The layover culture, the bottle-to-throttle arithmetic, and the private knowledge of exactly how close you have run it.
How the work actually runs alongside a flying schedule
Procedural, briefed, and honest about the system you are operating inside.
Before anything else, an honest baseline
The opening sessions establish what is actually happening: sleep, mood, drinking, the incident or loss that is still active, and how much of it is the schedule rather than something clinical underneath the schedule. Validated instruments give a baseline. Pilots tend to under-report by reflex, and a clinician who knows this population expects that and works with it rather than against it.
By session three or four you have a formulation, a plan, and a clear-eyed picture of where, if anywhere, the aeromedical system intersects with it. That picture is specific to you rather than to the worst story in the crew room, and knowing which one you are actually dealing with is itself part of the relief.
A clinician who has actually read the FAA's guidance
The FAA's May 2026 release included a document addressed to the psychotherapists who treat pilots and controllers, and it is worth knowing exists. It asks specific things of them: keep psychotherapy process notes separate from clinical progress notes so that a request for records does not sweep up the raw material of your sessions, write in precise DSM-5-TR terms, and avoid both upcoding and minimization. It ends by telling therapists who cannot work that way to think carefully before accepting a pilot at all.
That is not an academic point. A therapist who does not understand aviation can do real damage: an offhand diagnosis written into a note, a medication started without regard for certification, or a confident assurance about disclosure that was never theirs to give. What you want is a clinician who treats the person, understands the file, and says plainly when a question belongs to your AME rather than to them.
The order things change in: sleep first, identity last
Early: sleep quality, the intrusive replay of an event, the fuse at home during the seventy-two hours you actually get there. The drinking that had quietly become structural starts to look like what it is.
Later the work reaches identity: the certificate has become the person, so any threat to it reads as a threat to your existence, and retirement reads as an ending rather than a change. That fusion is workable, and it is far easier to work on before the date arrives than after.
Peer support and licensed treatment are different tools
For a lot of pilots the first call is a union or company peer program, and that is often the right first call: those programs exist to help, and they are staffed by people who fly what you fly. They are not clinical treatment, though, and it is worth five minutes to see which of the two the thing you are carrying actually needs.
| CEREVITY, Licensed Therapy | Union or Company Peer Support | |
|---|---|---|
| Who you are actually talking to | Licensed psychologists and clinicians (PhD, PsyD, LCSW, LMFT), each answerable to a state licensing board | Trained volunteer pilots and program staff, answerable to the program and to whoever runs it |
| Can assess and treat depression, anxiety, alcohol use, trauma | Yes: clinical assessment and evidence-based treatment, from the person doing the assessing | Not what it is built for; peer support listens and points you toward clinical care rather than delivering it |
| What confidentiality rests on | Therapist-client privilege plus HIPAA, on a record held by your clinician. Privilege is real but not absolute; the narrow legal exceptions get named at intake rather than discovered later | The program's own confidentiality policy, whatever that policy says. Reading it, and asking the program directly, is a reasonable thing to do first |
| Insurance record created | None. Private-pay by design: no claim, no diagnosis code, no carrier file | None either; peer support is not billed to insurance. What the program keeps in its own records is set by the program |
| Right for | Depression, anxiety, alcohol use, grief and incident carryover, sleep that the roster alone does not explain, when something is genuinely wrong and flying through it has stopped working | The call after a bad trip, a colleague who has flown the same line, and being pointed toward help. It works alongside treatment rather than in place of it |
Concierge by design: you never browse a directory
You tell us what you fly and how the month is actually built. We match you to a clinician who already works inside aviation.
Where we practice: nationwide. Our psychologists hold PsyPact authority across the participating states and individually licensed clinicians cover everywhere else, and licensure follows where you are physically located during the session rather than where you are based or domiciled. Tell your coordinator where the overnights and the days off actually happen, and matching plans around them. No office by design: no commute, no waiting room, nobody from the crew room in the lobby.
Get MatchedThe avoidance is documented, and the FAA is trying to fix it
of surveyed U.S. pilots reported a history of healthcare avoidance behavior because they feared losing their aeromedical certificate.
Source: Hoffman et al., Journal of Occupational and Environmental Medicine (2022)of airline pilots responding to a validated depression screen met the threshold for depression, and 4.1% reported having suicidal thoughts within the prior two weeks.
Source: Wu et al., Environmental Health, Harvard T.H. Chan School of Public Health (2016)is the FAA's stated initial deferral rate for all mental health diagnoses, while only about 0.1% to 0.2% of applicants who disclose a health issue and complete the process receive a final denial.
Source: Federal Aviation Administration, Fact Checking Medical Myths in AviationChoose your depth
Three session lengths, matched to the work in front of you. Most pilots settle into a weekly rhythm; some open with a longer block to build the map faster.
The standing weekly hour, booked around the bid: a cadence you can hold whether the week is a four-day or reserve.
90minExtendedNinety minutes for the sessions that keep ending mid-thought: the incident, the loss, the conversation at home that needs room to land.
3hoursIntensiveOne long block on a day off, when you want ground covered before the next trip rather than across the next quarter.
Treated by clinicians, reviewed by clinicians
Every CEREVITY clinician is independently licensed and works with pilots as core caseload, not a curiosity. This page is clinically reviewed by Martha Fernandez, LCSW, Co-Founder and Licensed Clinical Social Worker.
- PhD & PsyD psychologists with PsyPact mobility authority
- LCSW / LMFT / LPCC clinicians, multi-state licensed
- Evidence-based care: CBT, ACT, psychodynamic & somatic approaches
- HIPAA-secure telehealth; records stay between you and your clinician
One flight deck, one story
“I flew for eleven years telling nobody anything. Not my AME, not my wife, not the guy in the right seat. After my father died I was not sleeping and I was drinking on every layover, and I still would not call anyone, because I had convinced myself that one phone call ends the career. What finally moved me was getting a straight answer about what was actually true instead of what the crew room says is true.
Airline captain, narrow-body fleet, 15 months with CEREVITY
Shared with permission by a former client; identifying details altered to protect confidentiality. Individual experiences vary.
You run a checklist before every flight. You have never once run one on yourself.
Get Matched NowQuestions pilots ask before starting
Does CEREVITY report anything to the FAA, my AME, or my airline?
Does therapy show up as a diagnosis, or get me deferred?
What if I need medication?
I live in one state, I am based in another, and I am rarely in either. How does licensure work?
What does this cost?
Why does private-pay matter for a pilot specifically?
Go deeper
You are back on the line next week either way.
The question is what you are carrying into the flight deck with you. Matching takes one conversation, and most pilots are in session within 48 hours.
Seven days a week · Sessions 7 AM – 9 PM Pacific · Client support 8 AM – 8 PM Pacific · Concierge clients receive same-day priority